| NPI | 1285601104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA DAVID SHIELDS CEO 979-703-1407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0061609) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2020-11-13 |